Is it cold, allergy, or sinusitis?

This is the title of a fact sheet published by the American Academy of Otolaryngology – Head and Neck Surgery.  I’ve found this fact sheet during my preparation for (Upper Respiratory Tract Infection Concept Map).  And I’ve found that it would be so helpful for clinicians although it’s basically communicating patients.  The aim of this fact sheet is to educate patients about how to differentiate between the symptoms of cold, allergy, and sinusitis as they seem to be similar to each other.  Thus, patient who suspects bacterial sinusitis would see a doctor.

The comparison between the symptoms of cold, allergy, and sinusitis would help referral bodies – as pharmacists – be more informative to their patients.  Open Is-it-cold-allergy-or-sinusitis-fact-sheet?  fact sheet and don’t forget to subscribe to this blog to get my next concept map (Upper Respiratory Tract Infection).

Peptic Ulcer – 4 key points on patient education

Patient education regarding causes, risk factors, and therapy of peptic ulcer disease is very essential for peptic ulcer healing and for preventing ulcer recurrence.  In this post, I’m focusing on 4 key points on peptic ulcer disease patient education.  The aim of this post is to help healthcare professionals who deliver peptic ulcer disease patient education to be prepared with the required knowledge, and so to “be informative” for their patients.

1- Set treatment goals in participation with the patient.

The main treatment goals for peptic ulcer diseases are:

• Relief of ulcer pain
• Healing of ulcer
• Preventing ulcer recurrence
• Preventing complication

The patient should at least understand the importance of each of the previous goals.

2- Identify and modify risk factors.

This is achieved by: first, taking patient history regarding:

• presence of other illnesses,
• patient medication history; especially use of OTC drugs as non-steroidal anti-inflammatory drugs (NSAIDs) and use of corticosteroids, and
• lifestyle habits including diet, alcohol and cigarette smoking.

Then, helping the patient to modify these risk factors. 

For example, modifying NSAIDs administration for peptic ulcer disease patients who are in need for NSAIDs.  I’ve illustrated this issue on my post A2: Aspirin for PUD patients!  on this blog.  Another example, offering advice regarding diet and foods to avoid by peptic ulcer patients.

More peptic ulcer disease risk factors and their effects are illustrated in this mind map

Peptic Ulcer Disease Risk Factors – Part of Peptic Ulcer Disease Concept Map

3- Encourage proper medication use.

• encourage compliance to the specified regimens (whether it is Helicobacter pylori eradication regimen, proton pump inhibitor PPI therapy, … etc.) and educate the patient about the potential peptic ulcer disease complications (bleeding ulcer – perforation of stomach or duodenum – gastric outlet obstruction) that might occur if these regimens are not followed properly.  And make sure that the patient understands when to administer the medications.  For example, PPIs should be administered 15-30 minutes before meals.
• Identify potential drug – drug interactions by referring topatient medication history.  Among the important peptic ulcer medications that may cause drug interactions are proton pump inhibitors and H2-receptor blockers.
  
• Educate the patient about possible side effects that may make him/her stop taking the medications.

4- Always remember that good communication with the patient improves disease management.

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These are the points that I found most critical in educating peptic ulcer patients.  You might have other ideas regarding this topic so, please let me know them.  And if you find this topic useful, share it as much as you can.  Finally, think about the following questions and send me your answers in the comment box.

a- What are foods and drinks that peptic ulcer patient should avoid?

b- Patients taking both cimetidine and warfarin should have frequent blood monitoring to avoid bleeding. (True or False)

c- To overcome the gastrointestinal adverse effects of misoprostole, the dose is decreased and it’s administered with food. (True or False)

How to prepare for diabetes patient education?

Are you ready to educate a diabetic patient?! Let me give you some helpful tips:
1- Determine your objective. Your objective may vary from “participating in putting a disease management plan” to “just being helpful to your patient as he/she needs your help or advice”. Thus, determining your objective is very important to guide you through preparing yourself for diabetes patient education, as you need to know to which extent you have to be knowledgeable to educate your patient.
2- Prepare yourself for an effective conversation with your patient.  An effective conversation must be built upon getting information from the patient (input) then make use of it through an effective management plan or some advice (output). But between that (input) and this (output) an effective (preparation process) should be conducted. This process in my opinion consists of:
First, studying diabetes differently. Remember, this time you’re not studying diabetes or revising it to pass an exam. This time you’re studying diabetes to:

• Help in managing a diabetic case.
• Explain diabetes to a patient who doesn’t have a medical background.
• Answer potential questions by your patient.

What you need is to have a large picture for diabetes that helps you to speak confidently with your patient without forgetting any important point concerning the case. This is what I’m offering in (Diabetes Mellitus Concept Map Video) in my post (The Challange in Diabetes Concept Map). This map enables you to link between all aspects of the disease: definition, pathophysiology, types, etiology, risk factors, treatment, monitoring, patient education, etc… By studying (Diabetes Mellitus Concept Map) you would be able to see your patient as part of the map, while he/she is providing you with information (input).
Second, being ready with a brochure. Have you thought how will you start talking with your patient especially when this is a new service you’re providing in your pharmacy? Or have you thought how will your patient remember information you provide after he/she leaves the pharmacy? The answer is that you have to have a brochure for these purposes.
I’ve searched the internet a lot for a brochure that would help in simplifying information about diabetes for patients, and at the same time enthuses them to take care of their health by achieving the required tight glycaemic control. I actually have found a lot of helpful resources but almost all of them were in English or Spanish –I’m linking for them below for who are interested – but I’ve made my own Arabic brochure to suit people here in Egypt. You’re free to use it and to add your pharmacy’s name and you can also edit it as long as you keep the copyright.
Diabetes Mellitus Arabic Brochure.

نشرة توعية لمرضى السكر

 

 

 

 

 

 

Some DM English Brochures:

- Free Diabetes Education Materials for Patients and Professionals – Texas Diabetes Council.
- 4 Steps to Control Your Diabetes For Life – National Diabetes Education Program.

3- Evaluate your performance in parallel with your patient’s compliance and improvement, and then make modifications accordingly.

Hope these tips were useful for you … Till my next post, subscribe to this blog, share it and be informative!

Go Diabetes Mellitus Concept Map from Zoom out – Pharmacotherapy Website.

Intensive Glycemic Control + Monitoring = Low Complications = Low Cost

Let me tell you about some facts that I’ve read in a publication entitled “DIABETES AND THE PHARMACIST’S ROLE”:

• According to the American Diabetes Association (ADA), people with diabetes accounted for approximately $98 billion in health care expenditures in 1997. Many of these costs are associated with managing the complications of diabetes, such as myocardial infarction or  ischemic stroke, which have been estimated to cost $27,630 and $40,616, respectively.
• The American Diabetes Association (ADA) estimates that the complications and costs of diabetes could be reduced dramatically if patients maintained adequate control of their diabetes.  
• Results from the Diabetes Control and Complications Trial (DCCT) suggest that intensive treatment and monitoring for persons with Type 1 diabetes could reduce the risk of retinopathy (76%), nephropathy (50%), neuropathy (60%), dyslipidemia (34%), and cardiovascular disease (41%).
• Several studies have shown that disease management services are effective at improving the quality of care for persons with diabetes, which often translates into monetary savings for the health plan.
• The goal of this publication is to offer insight to community/ambulatory-based pharmacists on developing diabetes patient management services (DPMS) and demonstrating their value to patients  and payers.

 The big question that comes to my mind when I read an article like that is HOW to put this into practice?  As a pharmacist, what should I do?

You most probably have read articles that tell you “PHARMACIST HAS A CRITICAL ROLE IN …,” but when it comes into practice you find that the authors didn’t give you a “catalogue” for implementing this critical role whether it is related to patient education, screening for drug interactions and side effects, … etc.   

Regarding the issue of diabetes, take some moments to ask yourself:

• Am I prepared to educate a diabetic patient? 
• Do I have an organized and a complete picture about diabetes?
• Can I be sufficiently informative to a diabetic patient?
• Do I have a strategy to implement my “critical” role as a pharmacist regarding a diabetic patient?

 You are now face to face with a diabetic patient, what will you tell him/her?

In my next post ISA, I’ll give you some broad lines for educating a diabetic patient.  All what you have to do is to:

1- post your answer for the former question (as a diabetes educator, what are you going to tell your patient?), post about your experience with diabetic patients, or at least let me know your opinion about the topic and how much it is important to you,

2- then subscribe to this blog, so my next post about diabetic patient education reaches you.